〔大〕夫妇人血气心痛者，由脏腑虚，血气不调，风冷邪气乘于心也。其痛发有死
者，有不死者。成证者，心为诸脏之主，而主于神，其正经不可伤，伤之而痛者，名为
真心痛，朝发夕死，夕发旦死。心之支别络为风冷所乘而痛者，故痛发乍轻乍甚，而成
证者也。
〔薛〕前证若寒邪所伤，温散之。饮食停滞，消导之。肝火妄动，辛平之。脾气郁
结，和解之。仍与后六证方药同用。一妇人久患心痛，饮食少思，诸药到口即吐。予
以为脾土虚弱，用白术一味，同黄土炒，去土，每服一两，以米泔煎浓，徐服少许，数
日后自能大饮。用三斤余而安。上舍陈履学长子室，素怯弱，产后患疥疮，年余不愈，
因执丧旬月，每欲眩仆。一日感气，忽患心脾高肿作疼，手不可按，而呕吐不止，六脉
微细。或见其形实，误认诸痛不可补气，乃用青皮、木香、五味、吴茱萸等药而愈。继
复患疟，且堕胎，又投理气行血之药，病虽去，元气转脱，再投参 补剂不应矣，六脉
如丝欲绝。迎予至诊之，曰∶形虽实而脉虚极，反用理气之剂，损其真气故也。连投参、
、归、术、附子、姜、桂二剂，间用八味丸，五日寝食渐甘，六脉全复。此证若心脾
疼痛时，即服此等药，疟亦不作矣。
〔大〕乌药散 治妇人血气攻心痛，发歇不定。
乌药 莪术 桂心 当归（炒） 桃仁 青皮 木香（各等分）
为末，每服二钱，热酒调下。
阿魏丸 治妇人血气攻心疼痛，及一切积冷气。
当归 桂心 青皮 附子（炮） 阿魏（面裹煨，以面熟为度） 白术 川芎（各一两）
吴茱萸（炮） 木香 干姜（各三分） 槟榔 肉豆蔻（煨） 延胡索 莪术（各一两）
朱砂（细研，半两）
上为末，先以醋一升，煎阿魏成膏，和药末捣三百杵，丸如梧桐子大。每服二十丸，
食前热酒下。
鸡舌香散 治男子妇人九种心痛，一切冷气。
良姜（锉细，麻油炒） 桂心 赤芍药（各等分）
上为细末，每服二钱，水一盏，入盐木瓜三片，同煎七分，温服，盐汤点亦可。血
气疝瘕痛，用熟醋汤调下，忌生冷。
应痛散 治心脾痛不可忍者，妇人脾血气作心脾痛尤效。前方同，只无桂心。用醋
煎、醋汤点亦可。
乙丑年春初，次女年十五，经脉未行，初一日心痛如刺，吐饮不止，脉沉缓弦细，以
苏合香丸、神保丸、沉香丸、理中丸、诃子散、七气汤，皆无效。余思之，此证非虫即
饮作疾，非《局方》九痛丸则不可。遂合与服一二丸，即愈矣。
陈氏二神丸 治妇人血气不和，作痛不止，及下血无时，月水不调。
真蒲黄（炒） 荜茇（盐炒）
上等分为细末，炼蜜丸如梧子大。每服三十丸，空心温酒下。如不能饮，米饮吞下，
两服即止。
陈日华抽刀散 治妇人血风血气等疾。武兴戎司机宜侯恺云∶见一道人，用此方疗
病，不一而足，遂以为献，真是奇妙。
五灵脂（炒，一两） 莪术 桂心 芸苔子（炒，各半两）
上为末，每服二大钱，酒半盏，水半盏，煎至八分，疾作热服。
失笑散（见产后心痛。） 诃子散（见霍乱。）亦妙。
《灵苑方》治妇人卒血气心痛。只用生五灵脂为细末，每服一钱，酒一盏，煎沸热
服。
《局方》四七汤加良姜，又沉香降气汤、分心气饮，皆治心痛良。（三方并见杂病诸气。）
【大】妇女因血气失调引起的心痛，是由于脏腑虚弱，气血运行不调，风冷邪气侵袭心脏所致。这种疼痛发作时，有的会导致死亡，有的则不会。如果病情严重到形成证候，因为心是五脏的主宰，并且主宰精神意识，其正经（手少阴心经）不可受损伤，一旦受损而引发疼痛，称为真心痛，早晨发病傍晚就会死亡，傍晚发病第二天早晨就会死亡。如果是心的分支络脉受到风冷邪气侵袭而引发的疼痛，所以疼痛发作时有时轻有时重，从而形成一般的证候。
【薛】上述病症如果是寒邪所伤，应用温散法治疗；饮食停滞，应用消导法治疗；肝火妄动，应用辛平法治疗；脾气郁结，应用和解法治疗。仍然可以配合后面六种证候的方药一同使用。有一位妇人长期患心痛，食欲减退，吃药就吐。我认为这是脾土虚弱，于是只用白术一味药，同黄土一起炒制，去掉黄土，每次服用一两，用米泔水煎煮浓汁，慢慢服用少量，几天后自然能大量饮水。用了三斤多药后痊愈。上舍陈履学的长子之妻，素来怯弱，产后患疥疮，一年多未愈，因为守丧一个月，常常想要晕倒。有一天感受外气，突然患心脾部位高肿疼痛，手不能按压，并且呕吐不止，六脉微细。有人看到她的形体壮实，误认为各种疼痛不可以补气，于是使用青皮、木香、五味子、吴茱萸等药而治愈。后来再次患疟疾，并且流产，又投用理气行血的药物，病虽然去除了，但元气更加脱失，再投用人参补剂也不见效了，六脉如丝几乎要断绝。请我去诊治，我说：形体虽然壮实但脉象极度虚弱，反而使用理气的药剂，损伤了真气所致。连续投用人参、[人参/党参类，原文缺字]、当归、白术、附子、干姜、桂枝两剂，间或服用八味丸，五天后睡眠和饮食逐渐香甜，六脉完全恢复。这个病症如果在心脾疼痛时，立即服用这些药物，疟疾也不会发作了。
【大】乌药散：治疗妇女血气攻冲心痛，发作间歇不定。
乌药、莪术、桂心、当归（炒）、桃仁、青皮、木香（各等分）。
研为末，每次服用二钱，热酒调服。
阿魏丸：治疗妇女血气攻心疼痛，以及一切积冷气。
当归、桂心、青皮、附子（炮制）、阿魏（面粉包裹煨熟，以面熟为度）、白术、川芎（各一两）。
吴茱萸（炮制）、木香、干姜（各三分）。
槟榔、肉豆蔻（煨）、延胡索、莪术（各一两）。
朱砂（细研，半两）。
以上研为末，先用醋一升，煎阿魏成膏状，与药末混合捣三百下，制成梧桐子大小的丸剂。每次服用二十丸，饭前热酒送服。
鸡舌香散：治疗男女九种心痛，以及一切冷气。
良姜（锉细，麻油炒）、桂心、赤芍药（各等分）。
以上研为细末，每次服用二钱，加水一盏，放入盐木瓜三片，同煎至七分，温服，用盐汤点服也可以。如果是血气疝瘕疼痛，用熟醋汤调服，忌食生冷。
应痛散：治疗心脾疼痛难以忍受的，妇女脾血气导致的心脾痛尤其有效。前方相同，只是没有桂心。用醋煎服、醋汤点服也可以。
乙丑年春初，我的次女十五岁，月经尚未初潮，初一那天心痛如针刺，呕吐痰饮不止，脉象沉缓弦细，使用苏合香丸、神保丸、沉香丸、理中丸、诃子散、七气汤，都没有效果。我思考后认为，这个病症不是虫积就是痰饮作祟，如果不是《局方》中的九痛丸则无法治愈。于是配制给她服用一二丸，立刻痊愈了。
陈氏二神丸：治疗妇女血气不和，疼痛不止，以及非经期下血，月经不调。
真蒲黄（炒）、荜茇（盐炒）。
以上上等分为细末，炼蜜制成梧桐子大小的丸剂。每次服用三十丸，空腹温酒送服。如果不能饮酒，用米饮吞服，服用两次即可停止。
陈日华抽刀散：治疗妇女血风血气等疾病。武兴戎司机宜侯恺说：见到一位道人，用此方治病，屡试不爽，于是将其进献，真是奇妙。
五灵脂（炒，一两）、莪术、桂心、芸苔子（炒，各半两）。
以上研为末，每次服用两大钱，酒半盏，水半盏，煎至八分，疾病发作时热服。
[Da] Heartache in women caused by blood and qi disharmony results from deficiency of the zang-fu organs, irregular movement of blood and qi, and invasion of wind-cold pathogenic factors into the heart. Upon onset of pain, some cases may be fatal, while others are not. If the condition progresses to a syndrome stage, since the heart is the master of all zang-fu organs and governs the spirit (Shen), its primary meridian (Hand-Shaoyin Heart Meridian) must not be injured. Injury leading to pain is termed "True Heart Pain" (Zhen Xin Tong); if it occurs in the morning, death follows by evening; if it occurs in the evening, death follows by morning. If pain arises because the branch collaterals of the heart are invaded by wind-cold, the pain will fluctuate in intensity upon onset, forming a general syndrome.
[Xue] For the aforementioned conditions: if caused by cold pathogenic factors, apply warming and dispersing methods; if due to food stagnation, apply digestion-promoting methods; if due to reckless movement of liver fire, apply acrid-neutralizing methods; if due to spleen qi stagnation, apply harmonizing methods. These can still be used in conjunction with the prescriptions for the latter six syndromes. A woman suffered from chronic heartache, poor appetite, and vomiting immediately after taking medicine. I diagnosed this as deficiency of spleen earth and prescribed only Baid Zhu (Atractylodis Rhizoma). It was stir-fried with yellow loess soil, then the soil was removed. Each dose was one liang, decocted strongly in rice wash water, and taken slowly in small amounts. After several days, she could naturally drink large quantities. After using more than three jin of the herb, she recovered. The wife of the eldest son of Chen Luxue, a scholar of Shangshe, was inherently frail. She suffered from scabies postpartum which persisted for over a year. During a month-long mourning period, she frequently felt faint. One day, after contracting external pathogens, she suddenly developed swelling and severe pain in the heart and spleen regions, intolerable to touch, accompanied by incessant vomiting and faint, thin pulses in all six positions. Observers noted her robust physical appearance and mistakenly believed that tonifying qi was contraindicated for various pains. They treated her with Qing Pi (Citri Reticulatae Pericarpium), Mu Xiang (Aucklandiae Radix), Wu Wei Zi (Schisandrae Fructus), and Wu Zhu Yu (Evodiae Fructus), resulting in recovery. Subsequently, she contracted malaria and suffered a miscarriage. Further treatment with qi-regulating and blood-invigorating herbs eliminated the disease but further depleted her primordial qi. Subsequent administration of Ginseng tonics proved ineffective, and her pulses became thread-like and nearly imperceptible. Upon consultation, I stated: "Although her physique appears robust, her pulse indicates extreme deficiency. The previous use of qi-regulating agents damaged her true qi." I administered two doses of Ren Shen (Ginseng Radix et Rhizoma), [missing character, likely Dang Shen or similar], Dang Gui (Angelicae Sinensis Radix), Bai Zhu (Atractylodis Macrocephalae Rhizoma), Fu Zi (Aconiti Lateralis Radix Praeparata), Gan Jiang (Zingiberis Rhizoma), and Gui Zhi (Cinnamomi Ramulus), interspersed with Ba Wei Wan (Eight-Ingredient Pill with Rehmannia). Within five days, her sleep and appetite improved, and her pulses fully recovered. Had these medicines been administered at the onset of heart-spleen pain, the malaria would not have developed.
[Da] Wuyao San (Linseed Powder): Treats women's heartache caused by blood and qi attacking the heart, with irregular onset and cessation.
Wuyao (Linderae Radix), Ezhu (Curcumae Rhizoma), Guixin (Cinnamomi Cortex), Dang Gui (Angelicae Sinensis Radix, stir-fried), Taoren (Persicae Semen), Qing Pi (Citri Reticulatae Pericarpium Viride), Muxiang (Aucklandiae Radix) (equal parts).
Grind into powder. Take two qian per dose, mixed with hot wine.
Awei Wan (Asafoetida Pill): Treats women's heartache caused by blood and qi attacking the heart, and all types of accumulated cold qi.
Dang Gui (Angelicae Sinensis Radix), Guixin (Cinnamomi Cortex), Qing Pi (Citri Reticulatae Pericarpium Viride), Fuzi (Aconiti Lateralis Radix Praeparata), Awei (Ferulae Resina, baked in dough until dough is cooked), Baizhu (Atractylodis Macrocephalae Rhizoma), Chuanxiong (Ligustici Chuanxiong Rhizoma) (each 1 liang).
Wuzhuyu (Evodiae Fructus, processed), Muxiang (Aucklandiae Radix), Ganjiang (Zingiberis Rhizoma) (each 3 fen).
Binglang (Arecae Semen), Roudoukou (Myristicae Semen, baked), Yanhusuo (Corydalis Rhizoma), Ezhu (Curcumae Rhizoma) (each 1 liang).
Zhusha (Cinnabaris, finely ground, half liang).
Grind all into powder. First, boil one sheng of vinegar with Awei until it forms a paste. Mix with the powder and pound 300 times. Form pills the size of paulownia seeds. Take 20 pills per dose before meals, washed down with hot wine.
Jitexiang San (Cardamom Powder): Treats nine types of heartache in men and women, and all types of cold qi.
Liangjiang (Alpiniae Officinarum Rhizoma, finely cut and stir-fried in sesame oil), Guixin (Cinnamomi Cortex), Chi Shaoyao (Paeoniae Radix Rubra) (equal parts).
Grind into fine powder. Take two qian per dose with one cup of water, adding three slices of salted papaya. Decoct to seven-tenths volume. Take warm. Taking with salt water is also acceptable. For pain due to blood qi hernia and masses, take with warm vinegar solution. Avoid raw and cold foods.
Yingtong San (Pain-Relieving Powder): Treats unbearable heart and spleen pain; particularly effective for women's spleen-blood qi causing heart-spleen pain. Same formula as above, except without Guixin. Can be decocted with vinegar or taken with vinegar solution.
In early spring of the Yichou year, my second daughter, aged fifteen, had not yet begun menstruation. On the first day, she experienced stabbing heartache and incessant vomiting of fluids. Her pulse was deep, slow, wiry, and thin. Suhe Xiang Wan (Styrax Pill), Shenbao Wan (Divine Treasure Pill), Chenxiang Wan (Aquilaria Pill), Lizhong Wan (Regulate the Middle Pill), Hezi San (Chebulae Fructus Powder), and Qi Qi Tang (Seven-Qi Decoction) were all ineffective. I reasoned that this condition was caused either by parasites or phlegm-fluid retention, and only Jiutong Wan (Nine-Pain Pill) from the *Imperial Formulary* (*Ju Fang*) could cure it. I prepared and gave her one or two pills, and she recovered immediately.
Chenshi Ershen Wan (Chen Family Two-God Pill): Treats women's blood and qi disharmony causing persistent pain, non-menstrual bleeding, and irregular menstruation.
Zhen Puhuang (Authentic Typhae Pollen, stir-fried), Bibo (Piperis Longi Fructus, salt-stir-fried).
Grind superior quality ingredients into fine powder. Mix with refined honey to form pills the size of paulownia seeds. Take 30 pills per dose on an empty stomach with warm wine. If unable to drink alcohol, swallow with rice gruel. Cessation occurs after two doses.
Chen Rihua Choudao San (Chen Rihua Drawing-Knife Powder): Treats women's blood-wind and blood-qi disorders. Hou Kai, Military Commissioner of Wuxing, stated: "I saw a Daoist priest use this prescription to treat illnesses with repeated success. I submitted it as a tribute. It is truly miraculous."
Wulingzhi (Trogopteri Dung, stir-fried, 1 liang), Ezhu (Curcumae Rhizoma), Guixin (Cinnamomi Cortex), Yuntaizi (Brassicae Napus Seed, stir-fried, each half liang).
Grind into powder. Take two large qian per dose with half a cup of wine and half a cup of water. Decoct to eight-tenths volume. Take hot when symptoms arise.
Shixiao San (Smile-Lost Powder) (see Postpartum Heartache section) and Hezi San (Chebulae Fructus Powder) (see Cholera Section) are also excellent.
*Ling Yuan Fang* treats sudden blood-qi heartache in women. Use only raw Wulingzhi (Trogopteri Dung) ground into fine powder. Take one qian per dose with one cup of wine, boiled until hot, and taken warm.
Si Qi Tang (Four-Seven Decoction) from the *Imperial Formulary* (*Ju Fang*) with added Liangjiang (Alpiniae Officinarum Rhizoma), along with Chenxiang Jiangqi Tang (Aquilaria Descending-Qi Decoction) and Fenxin Qi Yin (Separate-Heart-Qi Drink), are all excellent treatments for heartache. (All three formulas are found in the Miscellaneous Diseases: Various Qi Disorders section.)